Technology has made tremendous inroads toward better healthcare and best medical practices in our society. Some, though lifesaving, have seemed intrusive and cold, perhaps saving practitioners time and money but doing little to improve the quality of life or ease of mind of their patients directly.
I’m thinking, for example, of the ways obstetrics became, in the latter half of the 20th century, rendering parturient women helpless or entirely unconscious during the natural process of childbirth.
Even the technological improvements in medical recordkeeping and appointment-making, meant to streamline a visit to the doctor’s office, can be irritating when computer systems between various clinics fail to sync up – or worse, when billing from multiple insurance models seems incomprehensible.
Some of us remember the good old days. But the slow world of the friendly country doc who knows everybody in town and carries a small black bag when visiting patients in their homes has long disappeared. The next-best thing – perhaps the way-better thing, given the pace and complexity of our lives these days – has now been perfected.
Recognizing the need for people to be in touch with their bevy of medical professionals in a much more direct manner, Dr. Anthony Bacchi developed a wearable device that monitors and streams vital signs, in real time, to an intervention center staffed by an interdisciplinary team of physicians and nurses. They are never out of reach. You are always in touch.
ImagineMIC produces a lightweight, disposable patch that is worn on the left side of the chest. It constantly streams information about your heartbeat, respiration and other hemodynamic data points to a central monitoring intervention center, where that diverse team of medical professionals tracks exactly how your body is doing, 24/7. It seems like such an obvious solution, but one that hadn’t been fully realized before.
That brings into question the vision and ambition of the company’s founder. Dr. Bacchi moved from practicing medicine to working in MagnaCare, a medical management corporation that provides its members insurance and healthcare services, and then to the nursing-home field, where he eventually purchased Golden Hill in Kingston. What he found in this industry was “geriatric warehousing”: a startling realization that prompted him to make changes in the way care was given to patients there.
Rachel McIntosh, ImagineMIC’s vice president of Implementation and Support, says, “Dr. Bacchi is successful in finding niches in healthcare where things need to be improved. In 2016, we started doing TeliStat, with a unit put in a nursing home where we take care of 18 high-activity patients using telemetry, along with a six-to-one nurse/patient ratio and critical care physicians.
“For that project, we got a grant from New York State for 4.5 million dollars, and the federal government matched that amount to fund research. We determined that if you improve care in the nursing home, you can decrease readmission and improve outcomes. Now we have ImagineMIC. We’ve taken the lessons learned from the nursing home and applied them to the home setting, too
“We found that when patients are discharged from the nursing home, although slightly improved, they’re really not all better. And now they’re on their own. They don’t have nursing care 24 hours a day or physicians making rounds on them. Oftentimes that will lead to decline in health or readmission to the hospital.
“One of the tools we use is this wireless patch. It monitors ECG: the rhythm and rate of your heart and your respiration. In addition, we give patients a blood pressure cuff, a pulse ox (a finger probe that tells us the oxygen level), a glucometer for sugar and a scale for weight, based on what their needs are. And they get a tablet that allows them to connect to the monitoring center, so they can speak to doctors and nurses directly.
“If we see an abnormality or change, we can call them on the tablet and say, ‘Hey, Mrs. Jones, I see your heart rate’s a little elevated,’ or they can call in to the monitoring center and say they’re not feeling so well. We also offer wellness calls: either a daily or several-times-a-week call to check in and make sure they’re taking their medications, their vital signs and they’re eating well, or did their home health aide come today? All those kinds of things. This program has been enormously successful already to reduce hospitalizations in the home and nursing-home settings. It’s another set of eyes monitoring them.”
When asked about the learning curve patients face after some sort of health crisis and are then sent home with these tools and all this new information, McIntosh reports that the process is so easy and streamlined that they typically don’t struggle. ImagineMIC goes into the home to set up the system for them. “All they have to do, so long as it stays charged, is touch one part of the screen that says: ‘Call Nurse.’ And if a call comes in, one part of the screen says: ‘Answer Call.’
“The other piece is what we call passive reporting. Patients don’t have to let us know their vital signs. If they take their vital signs, these stream passively into the monitoring center. Most monitoring programs do self-reporting, which depends on the patient’s compliance and willingness to participate. In this scenario, the patch is on your chest. All you have to do is wear it. The rest is done for you. We’re having a much greater success rate for usage and compliance because of that.”
I asked how long this technology has been in use by other manufacturers and how Dr. Bacchi got involved in the technology. “He’s a classically trained physician; however, he’s particularly clever in seeing how technology can be applied to the gaps in medicine. He collaborates with a team of technicians in what can and can’t be done. For instance, he wants to integrate facial recognition into this program so that patients don’t have to log in. This is the kind of forward thinking he has.
“What we found, as far as other technologies, is that there are a lot of scattered, patchy solutions. Sure, there’s been telemetry out there for years. But what is it without a clinician? The Apple Watch, for example. It’s great that it tells you have Afib, and now you have to go to the doctor. So it’s actually generating more medical care, as opposed to preventing it. It’s creating unnecessary visits to the doctor. Our program has the tools, and then we have the diagnosticians in the monitoring center who might say, ‘No, your rhythm looks fine; your heart rate is great. Let’s see how you feel in a little while. We’ll check back with you.’”
The patient is relieved from the stress and anxiety of having to make an appointment to go see the doctor. “We’ve taken the broken pieces of other people’s solutions, improved the technology, improved the process and combined it into one program. The patch is disposable. It’s so small, with two small batteries, a teeny antenna. It will last three to five days, then you take it off and put a new patch on. It’s water-resistant, and if it does get too wet, it turns off. When it’s dry, you can turn it back on.
“The monitoring center is the key factor that sets us apart. We have ER and critical-care-trained providers, because they are accustomed to filtering through information to determine if this is something that needs intervention or can it wait. This is beneficial to our patients because, when they call us for a wellness visit, we need the assessment skills to determine: Is this the person’s baseline, or has something changed? For a change-in-condition call, somebody has to decide: Is this something that needs intervention, should we call 911? Or is this something for which we can help the patient get an appointment to see their doctor? Or is this something we can treat right now? The monitoring center is the lifeblood of the program.
“Currently, ImagineMIC is licensed in New York and New Jersey, and our physicians need to be licensed to practice medicine in any state we go into. We’re looking into a national license agreement so our providers can practice medicine in any state. It’s an arduous process, but it will happen. Depending on scaling and growth, our capacity is as many computers as you can fit in a room. And the location of the monitoring center does not impact the care.”
Launched in June, the company continues to employ the latest technology in nursing homes as they roll out into individuals’ homes. “This is a comprehensive program that can help patients in all different settings. For example, if you get discharged from the hospital and we can take care of you in the nursing home, we can then follow you and continue to care for you in your home.
“What happens at times in transitions of care is that things get lost. The main thing that gets lost is the patient. Having somebody who can liaison between these different types of care will facilitate the patient’s wellness overall. If you go from the ER home, the medication list doesn’t always look the same. The patient then has to filter through and ask, ‘Is this a new medication? Do I have to keep taking the old one?’ It’s very confusing transition.
“Having somebody like us that can follow you through your care transitions bridges that gap and improves the outcome for the patient. We can be with you every step of the way and take the burden off the patient.”
I asked about people’s privacy issues when so much information is being gathered and everything is being taken out of our own hands. “We’ve had very little of that sort of concern. Most of the folks reaching out to us are welcoming our embrace. We’re HIPAA-compliant and cybersecure. You don’t have to worry about a breach in that sense. Your information will only be shared with healthcare providers involved in your care. We won’t reach out to you unless you want us to, or unless we see something for which you would want us to. Because we serve an older population and because it’s health-related, it’s not viewed as an invasion of privacy as much as it is a helping hand.”
For private pay for individuals, subscription to ImagineMIC costs about $350 a month, including all the equipment, the physician and nursing support, unlimited calls. Medicare and private insurance companies are not yet on board, and it takes a couple of years even to get a CPT code vetted and approved for any new medical service. “Once the government sees the cost benefits and reduction of the overall cost of care, it will be obvious that they should back this kind of program.”
We can only hope and wait. Meanwhile, Dr. Bacchi’s drive to innovate is hard to match, but he leads ImagineMIC employees in pursuit of the next improvement. McIntosh calls the Poughkeepsie office of the healthcare tech company, built at the former Dutchess Golf Club, an “idea factory.” Bacchi’s open-door policy is emphasized literally: The entire office is glass-walled for a transparent environment.
“If you have a thought, a plan, an idea, he looks for the best way to improve things, and his entrepreneurial nature exudes passion to make things better. He does a Town Hall-type thing, talks to the entire team. This lends the entire company that fire; it’s contagious. He thoroughly believes in what he’s doing. Retirement didn’t sit well with him. He designed and built the Lazy Swan Golf and Country Club in Saugerties, and he doesn’t even really play golf!”
For further information and inquiries, contact ImagineMIC at (845) 905-6192 and visit the website at www.imaginemic.com.